Respiratory Medicine Extra最新文献

Bordetella pertussis infection is often regarded by clinicians as a childhood illness, and the diagnosis may not be considered when adults present with respiratory symptoms. However, there is evidence that B. pertussis infection is considerably underdiagnosed in adults, who are susceptible as a result of waning immunity, and in whom the presentation may not be typical. Here, a case of an adolescent who was admitted to hospital with pneumonia due to B. pertussis infection is presented. Aspects of clinical presentation, diagnosis and epidemiology are discussed.

Chronic cough is a clinical problem that can be linked to multiple disorders stemming from a variety of anatomical sites. Successful treatment depends on determination of the precise cause and initiation of specific therapy. Here we present the case history of a 33-year-old man with chronic cough due to multiple causes. Although the patient's most common complaints were treated, cough persisted. Long-term clinical follow-up led to a definitive diagnosis of a cranial nerve dysfunction syndrome, and cough resolved after successful specific treatment.

Sarcoidosis is a multisystem disease of unknown etiology that predominantly affects intrathoracic lymph nodes and lungs. Although the diagnosis of sarcoidosis in some cases may be established on the ground of the clinical and radiological pattern, the American Thoracic Society in the 1999 statement emphasized that the diagnosis of sarcoidosis requires “histological demonstration of no necrotizing granulomas” [Hunninghake GU, Costabel U, Ando M et al. Statement on sarcoidosis. Am J Respir Crit Care Med 1999; 160: 736–55]. We present the case of a very rare presentation of sarcoidosis as a polypoid endobronchial lesion coexisting with lymph node involvement. Diagnostics of sarcoidosis was confirmed in the histological examination of the specimens both from the lymph node and the polypoid lesion.

Primary tracheal schwannoma is exceptional and may simulate asthma. We report a new case of tracheobronchial schwannoma mimicking severe asthma in a 37-year-old man. Histologic diagnosis is made by surgery after the failure of the endoscopic resection. This tumor, even rare, must be considered in the differential diagnosis of patients with obstructive airway symptoms, especially if unresponsive to conventional therapy.

We describe the case of a woman presenting with fever, dyspnea, and hypoxemia, who had taken isoniazid, rifampin, pyrazinamide, and ethambutol under the diagnosis of tuberculosis. Her clinical and radiological presentations were of acute lung injury, which was confirmed by lung biopsy. At that time, a possible connection between acute lung injury and ethambutol was postulated. Her symptoms rapidly improved only two days after discontinuation of antituberculous drugs. Isoniazid, rifampicin, and pyrazinamide were resumed without any recurrence of acute lung injury. We report a case of acute lung injury induced by ethambutol with a brief review of the literature.

Hemoptysis is often the first indication of pulmonary tuberculosis. We report the case of a 25-year-old diabetic patient who presented with pulmonary tuberculosis complicated by massive hemoptysis. Bronchial arterial embolisation was achieved urgently and stopped the bleeding. Surgery is usually contra indicated in active widespread tuberculosis. Bronchial arterial embolisation has been established as an effective alternative to surgical resection in such cases.

Excessive usage of creams and other oil-based material to face, scalp and hair may be a source for causing exogenous lipoid pneumonia (EPL), and potentially hazardous health consequences to patients. Since it is often unrecognized, awareness of this condition by clinicians, timely advise to patients with corrective measures, simple withdrawal and cessation of excessive application of these agents by patients, may result in amelioration of their symptoms and prevent potentially serious complications. To emphasize on this important and preventable health hazard, we report a case of EPL associated with spontaneous pneumothorax, rarely mentioned in the literature, that was caused by application of Vaseline to scalp, hair and face and coco-butter to face and withdrawal of these agents led to resolution of the condition. To our knowledge, this probably is the first reported case of pneumothorax associated with EPL.

Behcet's disease (BD) is a vasculitis affecting arteries and veins. However, intracardiac thrombus is very rare in BD. Here we present a case of BD with wide spread thrombi and intracardiac thrombus.

We present a case of pulmonary hyalinizing granuloma (PHG) associated with a history of pleural effusion, autoimmune thyroiditis and spontaneous ecchymosis especially periorbitally. She presented with complaints of dyspnea, cough and chest pain. Two right-sided pulmonary nodules were resected and proved to be PHG histopathologically. After a 2 years follow up, we have seen multiple bilateral nodules of varying size which were considered as recurrence by excluding all possible primary or metastatic malignancy.

We assessed pain induced by radial artery puncture (AP) and its possible relief through topical anesthesia by lidocaine–prilocaine (LP) patch in 103 patients divided into 3 groups: AP was performed without any topical preparation, or after application of a placebo or a LP patch. The AP-induced painful sensation was moderate and not reduced by LP. It did not depend either on patient's sex and anxious state, or on the nurses performing AP. This study demonstrates that AP performed by experienced nurses does not necessitate a previous topical skin anesthesia.